In this episode of Under Your Skin, host Nicholas Brownstone, MD, chats with guest Andrew Alexis, MD, MPH, about the public perception of dermatology, therapeutic gaps for challenging pigmentary conditions, and balancing aesthetics and medical dermatology in the clinic. 

The incomplete public perception of dermatology 

They begin by discussing the public perception of dermatology, noting that the general public may not fully grasp the extent of dermatologists' contributions. 

Dr Alexis highlights the diversity of the specialty and its profound impact on individuals' lives. He emphasizes that dermatology encompasses a wide spectrum of care, ranging from aesthetics to inflammatory conditions, infectious diseases, and diagnosing internal diseases through cutaneous manifestations, noting the myriad ways in which dermatologists positively influence patients' well-being. 

Therapeutic gaps for pigmentary disorders 

Transitioning to therapeutic considerations, Dr Alexis acknowledges the remarkable recent advancements in dermatology. However, he underscores the persistent need for better therapies, particularly for pigmentary conditions such as lichen planus pigmentosus and erythema dyschromicum perstans, or ashy dermatosis. These challenging conditions pose treatment difficulties due to limited therapeutic options, and Dr Alexis expresses hope for future breakthroughs in identifying new targets and developing effective therapies to address these unmet needs. 

The intersection of aesthetics and medical dermatology 

Shifting focus to aesthetic dermatology, Dr Alexis provides insights into the evolving landscape of his practice. He shares that approximately 40% of his time is dedicated to performing aesthetic procedures, such as lasers, peels, and injectables, and that he anticipates a continued increase in the demand for aesthetic services over time. Many of Dr Alexis' aesthetics patients initially sought medical dermatology care but later returned for aesthetic procedures to address additional concerns. This trend underscores the intersection between medical and aesthetic dermatology and highlights the expanding role of dermatologists in meeting patients' diverse needs.